PFI2017-00171 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12017-00171
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 08/23/2017
Parcel: SEG1167
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Zayo PFI
Project Description: Overlash new fiber optic cable to existing strand and place new underground facilities by means of
trench on SW Hampton st within the City of Tigard ROW.
Owner: FEES
Description Date Amount
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
BRIAN DAVIDSON
18110 SW 34TH ST SUITE 100
VANCOUVER,WA 98683
PHONE: 503-907-5528
Total $0.00
Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact
information of responsible parties before beginning work.
Perm ittee/Applicant
See application
Signature:
Issued By: �-�--
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12017-00171
Type: Condition Name: Status: Severity:
PFI_Utilities 01 -WORK SITE REQUIREMENTS Applied Notice
Applicant must comply with all applicable provisions of federal and state law,the Tigard Municipal Code,and the terms of
any agreement with the City of Tigard regarding work to be done pursuant to this permit.
PFI_Utilities 02-WORK SITE AREA Applied Notice
The work area and approach roads shall be maintained in a clean condition,free from obstructions and hazards. The
spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited
and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up
and suspension of work to accomplish clean-up.
PFI_Utilities 03-WORK SITE EROSION CONTROL Applied Notice
Prior to starting work,effective and approved erosion control devices must be installed and maintained meeting the Clean
Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to
accomplish effective erosion control.
PFI_Utilities 04-WORK SITE REPAIRS Applied Notice
Disturbed landscaped areas shall be restored or replaced. Existing signs, pavement markings, mailboxes,etc. shall be
reinstalled or replaced,with like kind of material. Obtain City approval of restoration work.
PFI_Utilities 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice
Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices
[MUTCD]for Streets and Highways", U.S. Dept.of Transportation, FHWA,current edition,American Traffic Safety Services
Association[ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH].
PFI_Utilities 06-TRAFFIC CONTROL PLAN Applied Notice
Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work
area.Traffic control devices,flag persons, etc., shall be in place prior to initiation of construction work and shall be
effectively maintained.
PFI_Utilities 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice
Public roadway shall not be closed to traffic, at any time,without obtaining written approval from the City Engineer. The
applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and
area wide Emergency Services: 503-629-0111 (Tigard Police Dept.,Tualatin Fire&Rescue)and to 503-962-8140(Tri-Met)
and 503-431-2345(Tigard School District)and other service providers impacted by such closure.
PFI_Utilities 08-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice
Access to existing properties shall be maintained at all times, including normal delivery service and mail service.Obtain City
approval of any access closures.
PFI_Utilities 09-TRAFFIC CONTROL WORK HOURS Applied Notice
Work is permitted in daylight between the hours of 7:00 a.m.to 7:00 p.m. Mon-Fri unless otherwise authorized by the City.
PFI_Utilities 10-TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice
Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the
City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m.to 9:00 a.m. unless authorized
by the City Engineer.
PFI_Utilities 11 -TRAFFIC CONTROL MODIFICATION Applied Notice
The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to
assure public safety.
PFI_Utilities 12-UTILITY NOTIFICATION Applied Notice
Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR
952-001-0100 through OAR 952-001-0080. Copies of said rules may be obtained from the Center by calling 503-246-1987.
If you have any question about the rules,contact the Center. NOTE: Damage to utilities shall be corrected at the permit
holder's expense.
PFI_Utilities 13-UTILITY LOCATION CONFLICT Applied Notice
Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole
before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at
the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work
with affected utility agencies.
PFI_Utilities 14-TEMPORARY PATCH Applied Notice
A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance
approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is
liable for hazards or damage resulting from the prosecution of the work.
PFI_Utilities 15-REPAIR OF EXISTING FACILITIES Applied Notice
Work under this permit shall include repair of existing facilities(roads,ditches, etc.)as may be necessary, as determined by
the Inspector,to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit.
Corrective work shall be done at the applicant's expense.
PFI_Utilities 16-PRECONSTRUCTION MEETING Applied Notice
Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Insert Name>at<Insert
Phone#>, to establish a preconstruction meeting.
PFI_Utilities 17-NOTICE TO COMMENCE WORK Applied Notice
The applicant shall notify the City's Inspector twenty-four(24)hours prior to commencing work, prior to any staged
inspection,and after completing work covered by the permit.
PFI_Utilities 18-PERMIT/PLAN ON SITE Applied Notice
A copy of the permit including a Certificate of Insurance, and all attachments, and a copy of the approved construction plan
and all amendments shall be readily available at the work area. All work shall conform to the permit terms,conditions and
provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and
specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work
performance.
PFI_Utilities 19-MONUMENT PROTECTION Applied Notice
Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's
expense.
PFI_Utilities 20-EMERGENCY CONTACTS Applied Notice
Provide to the City inspector, in writing,the names and 24 hour emergency telephone number of two(2)persons who have
authority to resolve problems,take corrective action and, in general,will be responsible in case of any emergency. The
applicant shall notify the City Inspector, in writing, of any/all assignment changes.
PFI_Utilities 21 -OTHER Applied Notice
RECEIVE®
City of Tigard AUG 15 2017
PUBLIC WORKS — ENGINEERING CITY OF TIGARD
CANNING/ENGINEERING
Public Facility Improvement (PFI) Kermit
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
8 TYPE 1-Franchise Utility Work
Check one: IR Utilities ❑ Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE
Detailed description:
Zayo proposes to overlash new fiber optic cable to existing and/or utility agency.
strand and place new underground facilities by means of trench on SW Hampton St ❑ TYPE 2-Sidewalk/Driveway/Sewer
within the City of Tigard ROW.See attached drawing for more detail. Work performed for the purpose of:
• Sidewalk installation or repair.
7105 SW Hampton St • Driveway approach installation
Property address/location(s): /- P and/or repair
• Sanitary sewer lateral installation
and/or main line tap
Applicant: Electric Lightwave El TYPE 3-Full scale Development
pp Work performed with Land use
Address: 18110 SE 34th Street, Building One, Suite 100 approval which includes any of
City/state: Vancouver,WA Zip. 98683 the following:
Phone: (360)558-4215 Email: Brian.Davidson@electriclightwave.com • Subdivisions or Partitions
Brian Davidson 503 907-5528 • Street widening
Contact name: Phone: � )
• Mainline installation for Sanitary
Contractor: Standard Utility Contractors sewer, Storm sewer, Tigard water
CCB#: 66948 Expiration: 5/29/2017 and/or Tigard Water Service Area
Address: PO Box 1008 SUBMIT COMPLETED APPLICATION TO:
City/state: Salem, OR Zip. 97308 City of Tigard
Phone: (503)678-3030 Email: darnel@standardutility.com Planning/Engineering
13125 SW Hall Blvd.
Contact name: Darrel Williams Phone: (503)849-4828 Tigard,OR 97223
Applications for"minor work in right-of-way"
Engineer: K&B Technical Solutions only may be emailed to:
Address:
6566 SE Lake Rd mm:permitsatigard-or.gov
City/state: Milwaukie,OR Zip: 97222 rrnn,�,,
Phone: (503)650-6041 Email: Justen_Phllips@kbmail.net Case No.: PUSCJ � 7 " 00) 7/
Contact name: Justen Phillips
Application submittal fee: $
Additional fees: $
Estimated value of work is required(if over$5,000):$ Application accepted:
(within the public right-of-way) By: Date: ' I 17
Is work related to a LAND-USE DECISION? ❑ Yes I@ No APplica ' n reviewed-
Is
If so,please specify (MLP, SDR,SUB,etc.) case#:
Applica1 t notified:
Is work related to a BUILDING PERMIT? ❑ Yes IM No By: S Date:
If so,please specify(BUILDING PERMIT)case#: l:\ENG\PermitApplications\pfi_application Rev.12/16/2016
Cityof Tigard e 13125 SW Hall Blvd. • Tigard,Oregon 97223 e www.tigard-or.gov 0 503-718-2421 • Page 1 of 4
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APPLICANTS j
NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for work,if
required by the city pursuant to TNIC 15.041.140. I
* With the exception of a utility operating pursuant to a valid franchise with the City of Tigard,when the owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written authorirhtion from the owner or an agent of the
owner. The owner(-)must sign this application in the space provided or submit a written authorirition with this applicati<m. Fraachised j
Utilities are riot required to obtaut the owner's signature on the application
BY SIGNING BELOW,THE APPLICANT(S)SHALL CERTIFY THAT:
• The above request does not violate any recorded deed restrictions that may be attached to or unposed upon the subject
}�-r�pertu'•
• If the application is granted,the applicant will exercise the tights granted hi accordance with the terms and subject to all the
conditions and limitations of the approval.
• All of the above statements and the statements in any plot plan,attachments,and exhibits transmitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such
statements are false.
• The applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or denying the application.
i
�0on
�av�ISM Brad Rollins for Brian Davidson 8/15/2017
Applicant/Authorized Agent's signature Print name Date
SIGNATURES of each owner of the subject property, if requited.
Owner's signature Print name Date
Owners signature Print name Date
Owner's signature Print name Date
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PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • -,vww.tigard-or.gov 503-718-2421 Page 2 of 4
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DEVELOPMENT ENGINEERING FEES YOR SI AIT t SE ONLY
Public Facility Improvement(PFI)Permit: DETAILE'D SUBMITTAL
APPLICATION FEE
Part 1: Required submittal fee$300.00
FRANCHISE UTILITY AND SIDEWALK/
PERMIT FEE DRIVEWAY AND UTILITY
Part 2: All non-water system improvements CONNECTIONS,ETC.
Engineer's estimate X 5%(less$300.00 submittal fee) (work in the right of way)
Engineer's estimate X 2%Plan Review Sketch
(including information below)
WATER SYSTEM FEE
❑ Dimensions
Part 3: All public water system improvements ❑ Street Name
Engineer's estimate X 12% ❑ Site Address
PFI Permit Fee Exemptions: FULL SCALE DEVELOPMENT
There will be no permit fee charged,or assurance required
(Subdivisions/Partitions and Street Improvements)
for the following types of work:
• Sidewalk repair(less than 20 lineal feet)
• Relocate or replace mailbox Design Plans
• Ditch cleaning that does not involve regrading. (6 sets,24x36 or 22x34)
• Weep hole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend
• Curb repair or replacement(less than 20 lineal feet) ❑ General Notes(City,Water,Sewer,etc.)
• Lawn sprinkler system installation or repair ❑ Street(Plan,Profile)
• Street tree pruning or planting ❑ Water,Storm and Sanitary(Plan Profile)
• Planter strip landscape maintenance ❑ Water Quality Facilities
• Test wells ❑ Grading
❑ Landscaping/Tree Plan
❑ Composite Utility Plan(Electrical,Phone,Gas,
Note: A cash assurance may be required per Storm,Sanitary,Water,Signage,Street Lights,etc)
TMC 15.04.140.(customer deposit) ❑ Details
❑ Traffic Sight Distance
❑ Signing and Striping
❑ Street Light Plan and Photometric
❑ Engineers seal/signature
❑ Sheet label(project land use name,revision and
plan log block,dates and sheet numbers.)
Additional Submittals
(per Land Use conditions)
❑ Traffic Report
❑ Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of 4
SAMPLE SKETCH:
Edge of Pavement
Ditch -4W
Streetlight I — -------------r---
• " Rtin in
Dm
' a
I I tri..P.fnzr 1
1 6
' i—propos d'Se1werTirie"
N� I 1
�,� Existing House
Existing
21
i Driveway
a;
CI w I ' pry•
IL l est �1
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IL
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O'
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.
Existing Shop �
_ 1
Power` o . 2
I a 95' 1
------7roper -Lane------i---
� I O
1
II Fire Hydrant(FH)
� � I
Scale: 1"=30'
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MINIMUM SKETCH REQUIREMENTS (Put"N/A"if Not Applicable):
North arrow Property lines& dimension Slope of property
Street &street name(s) Existing building, structures Utility&street light poles
Proposed work Existing curb or edge Trees
Existing S/W or of pavement Existing utility locations
D/W apron (sewer,water,storm)
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard - 13125 SW Hall Blvd. - Tigard,Oregon 97223 - www.tigard-or.gov - 503-718-2421 - Page 4 of 4
R R
R TRENCH DETAIL CONSTRUCTION NOTES
R
1. ALL WORK AREAS TO BE RESTORED TO LME OR BETTER
CONDITION.
R
2.ALL OTHER UIIITES ARE BASED prF EXISTING LOCATES
7105 R DIE UTILITY STRUCTURES.
0, '1,7
RATTK / S.T IS THE CONSTRUCTION CONTRACTORS RESPONSIBILITY
CD'P11°" ' nLL; R 0' 20' 40' TO CALL FOR LOCATES BER)RE DOGGING
L7SCALE: 1'=20' R LEGEND
EXISTING UTILITY POLE
PROPOSED RISER �R
R R EXISTING STRAND
PR INK 8 O T M TRENCH
U EXISTING STORM DRAIN
PoGHT OF WAY
FACE OF CURB/
EDGE OF PAVEMENT
EXISTING SIDEWALK
R
1RETICH TO PLACE(1)-2' CABLE TO NEW NG S OPTIC
�CONWR AND FIBER A MIN. END UNDERGROUND CABLE TO EXISTING STRAND.
OF 36"BELOW GRADE CONSTRUCTION IN
CITY OF TIGARD ROW. BEGIN AERIAL CONSTRUCTION
AT IXISTING 11i1L1�tt POLE IN
CITY OF TIGARD ROW.
9 SID 87 POLE f620
P tE — — — — — — — 1
6' FROM FOC
S � END AERIAL CONSTRUCTION AND�^ � �— -�— ^ � �� � m ;ay
BEGIN UNDERGROUND
CONSTRUCTION AT EXISTING UTILITY
POLE IN CITY OF TIGARD ROW. Contact:Joseph Klelnsasser
Title:OSP Project Manager
SIN NAYPlm sr ph:(720)549-2293
cell:(541)979.8039
emal:iosePh.klelnsasser4bzayo.rAm
IQ5Po IoX 2329
Clack—.OR 97015
DeMon By.K d B(503)3506041
TECHNICAL SOLUTIONS E-1:Just PMaPs®kb—1 n,.
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7100
7000 • s�E:
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SHEET NUMBER
R Fiber Enhancement Project
E o o,,,,, ,, , ,,,•,, 7105 SW Hampton St
Tigard,OR 97223
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Page 106 2011 Edition
Diversion into a Continuous Left Turn Lane Diagram 430
Diagram 430 shows work in the travel lane(s) next to a continuous two-way
left turn lane with one direction of traffic diverted into the continuous two-way
left turn lane.
1. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3—Lights and Lighted Signs for exceptions.
2. For added visibility, a truck-mounted arrow board or PCMS in caution
mode may be used.
3. When two or more travel lanes are reduced to a single lane before the
diversion, each lane shall be closed separately. Layout traffic control
according to ODOT Standard Drawing TM 852 for 5-lane sections.
4. A shifting taper(L/2) may be added in the diverted traffic direction
across the continuous two-way left turn lane(as shown). This option is
recommended when the speed is 45 mph or greater.
Sign Spacing and Buffer Lengths(feet)
Posted Spacing Between Signs "Buffer"
Speed A B C Space
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 107
Diversion into a Continuous Left Turn Lane Diagram 430
ROAD
WORK
AHEAD
B
1 �y t
D�
LME
CLOSED
AHEAD
A
II
U2 I . I
I softer
Protection Vehicle
w/TMA(both Optlonaq
See Chapter 4
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Buffer
•
• L/2
I �
•
U2 I• I A
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lyt B
I I WOR
AHEAD
September 2016 Chapter 5